I 

116TH CONGRESS 

1ST SESSION H. R. 3016 

To amend the Public Health Service Act to provide for and support liver 

illness visibility, education, and research, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 23, 2019 

Ms. VELA ́ZQUEZ (for herself, Mr. ESPAILLAT, Ms. LEE of California, Mr. 

FITZPATRICK, Ms. GABBARD, Mr. VELA, and Ms. NORTON) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce 

A BILL 

To amend the Public Health Service Act to provide for 

and support liver illness visibility, education, and research, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Liver Illness Visibility, 

5 Education, and Research Act of 2019’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) Liver cancer is the fastest-growing cause of 

2 cancer death in the United States and among the 

3 leading causes of cancer deaths globally. 

4 (2) In 2018, approximately 42,220 people in 

5 the United States will be diagnosed with primary 

6 liver cancer, and approximately 30,200 will die from 

7 the disease. 

8 (3) Liver cancer is a leading cause of cancer 

9 death among the Asian-American and Pacific Is10 lander community. 

11 (4) The most vulnerable Asian-Americans are 

12 those who are foreign-born, low-income, and living in 

13 ethnic enclaves. 

14 (5) Asian and Pacific Islander men and women 

15 are more than twice as likely to develop liver cancer 

16 compared to the non-Hispanic White population. 

17 (6) Among the Asian and Pacific Islander pop18 ulation, the higher incidence rate of liver cancer is 

19 partially explained by higher incidence rates of Hep20 atitis B and diabetes, which are comorbidities shown 

21 to increase an individual’s risk of developing liver 

22 cancer. 

23 (7) The most common causes of liver cancer in24 clude Hepatitis B virus and Hepatitis C virus infec25 tion. 


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1 (8) Hepatitis B is a primary risk factor for de2 veloping liver cancer, and 1 in 4 of those chronically 

3 infected with hepatitis B develop cirrhosis, liver fail4 ure, or liver cancer. 

5 (9) Half of all individuals with hepatitis B in 

6 the United States are Asian-American or Pacific Is7 lander, though this group accounts for only 5 per8 cent of the U.S. population. 

9 (10) Among African immigrants in the United 

10 States, the prevalence of hepatitis B infection is ap11 proximately 1 in 10, and African immigrants make 

12 up 30 percent of those with chronic hepatitis B in13 fection in the United States. 

14 (11) Among Hispanic/Latino communities, liver 

15 cancer incidence and death rates are twice as high 

16 compared to the non-Hispanic White population. 

17 (12) Hispanics/Latinos are 60 percent more 

18 likely to die from viral hepatitis than non-Hispanic 

19 Whites. 

20 SEC. 3. LIVER CANCER AND DISEASE RESEARCH. 

21 Subpart 1 of part C of title IV of the Public Health 

22 Service Act (42 U.S.C. 285 et seq.) is amended by adding 

23 at the end the following new section: 


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1 ‘‘SEC. 417H. LIVER CANCER AND DISEASE RESEARCH. 

2 ‘‘(a) EXPANSION AND COORDINATION OF ACTIVI3 TIES.—The Director of the Institute shall expand, inten4 sify, and coordinate the activities of the Institute with re5 spect to research on liver cancer and other liver diseases. 

6 ‘‘(b) PROGRAMS FOR LIVER CANCER.—In carrying 

7 out subsection (a), the Director of the Institute shall— 

8 ‘‘(1) provide for an expansion and intensifica9 tion of the conduct and support of— 

10 ‘‘(A) basic research concerning the etiology 

11 and causes of liver cancer; 

12 ‘‘(B) clinical research and related activities 

13 concerning the causes, prevention, detection, 

14 and treatment of liver cancer; 

15 ‘‘(C) control programs with respect to liver 

16 cancer, in accordance with section 412, includ17 ing community-based programs designed to as18 sist members of medically underserved popu19 lations (including women), low-income popu20 lations, or minority groups; and 

21 ‘‘(D) information and education programs 

22 with respect to liver cancer, in accordance with 

23 section 413; 

24 ‘‘(2) issue targeted calls for proposals from re25 search scientists for purposes of funding priority 

26 areas of liver cancer research; 


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1 ‘‘(3) establish a special emphasis panel (as de2 fined by the National Institutes of Health) to review 

3 any proposal submitted pursuant to paragraph (2); 

4 and 

5 ‘‘(4) based on reviews by the special emphasis 

6 panel under paragraph (3), select which proposals to 

7 fund or support. 

8 ‘‘(c) INTER-INSTITUTE WORKING GROUP.—The Di9 rector of the Institute shall establish an inter-institute 

10 working group to coordinate research agendas focused on 

11 finding better outcomes and cures for liver cancer and 

12 other liver diseases, including hepatitis B. 

13 ‘‘(d) GRANTS AND COOPERATIVE AGREEMENTS.— 

14 ‘‘(1) IN GENERAL.—The Secretary may award 

15 grants and enter into cooperative agreements with 

16 entities for the purpose of expanding and supporting 

17 research on— 

18 ‘‘(A) conditions known to increase an indi19 vidual’s risk of developing a major liver disease, 

20 such as liver cancer, hepatitis B, hepatitis C, 

21 nonalcoholic fatty liver disease, and cirrhosis of 

22 the liver; and 

23 ‘‘(B) opportunities for preventative and di24 agnostic measures for such a disease, including 


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1 the study of molecular pathology and biomark2 ers for early detection of such disease. 

3 ‘‘(2) EXPERIMENTAL TREATMENT AND PRE4 VENTION.—In the case of an entity that is a hospital 

5 or a health care facility, the Secretary may award a 

6 grant or enter into a cooperative agreement with 

7 such an entity for the purpose of supporting an ex8 perimental treatment or prevention program for liver 

9 cancer carried out by such entity. 

10 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

11 For purposes of carrying out this subsection, there 

12 is authorized to be appropriated $45,000,000 for 

13 each of fiscal years 2020 through 2024. Any 

14 amounts appropriated under this paragraph shall re15 main available until expended.’’. 

16 SEC. 4. LIVER CANCER AND DISEASE PREVENTION, AWARE17 NESS, AND PATIENT TRACKING GRANTS. 

18 Subpart I of part D of title III of the Public Health 

19 Service Act (42 U.S.C. 254b et seq.) is amended by adding 

20 at the end the following new section: 

21 ‘‘SEC. 330N. LIVER CANCER AND DISEASE PREVENTION, 

22 AWARENESS, AND PATIENT TRACKING 

23 GRANTS. 

24 ‘‘(a) PREVENTION INITIATIVE GRANT PROGRAM.— 


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1 ‘‘(1) IN GENERAL.—The Secretary, through the 

2 Director of the Centers for Disease Control and Pre3 vention, may award grants and enter into coopera4 tive agreements with entities for the purpose of ex5 panding and supporting— 

6 ‘‘(A) prevention activities (including pro7 viding screenings, vaccinations, or other pre8 ventative treatment) for conditions known to in9 crease an individual’s risk of developing a major 

10 liver disease, such as liver cancer, hepatitis B, 

11 hepatitis C, nonalcoholic fatty liver disease, and 

12 cirrhosis of the liver; 

13 ‘‘(B) activities relating to surveillance, 

14 diagnostics, and provision of guidance for indi15 viduals at high risk for contracting liver cancer 

16 and other liver diseases; and 

17 ‘‘(C) a robust hepatitis surveillance infra18 structure to provide for timely and accurate in19 formation regarding progress to eliminate viral 

20 hepatitis. 

21 ‘‘(2) REPORT.—An entity that receives a grant 

22 or cooperative agreement under paragraph (1) shall 

23 submit to the Secretary, at a time specified by the 

24 Secretary, a report describing each activity carried 

25 out pursuant to such paragraph and evaluating the 


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1 effectiveness of such activity in promoting prevention 

2 and treatment of liver cancer and other liver dis3 eases. 

4 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

5 For purposes of carrying out this subsection, there 

6 is authorized to be appropriated $90,000,000 for 

7 each of fiscal years 2020 through 2024. Any 

8 amounts appropriated under this paragraph shall re9 main available until expended and shall be used to 

10 supplement and not supplant other Federal funds 

11 provided for activities under this subsection. 

12 ‘‘(b) AWARENESS INITIATIVE GRANT PROGRAM.— 

13 ‘‘(1) IN GENERAL.—The Secretary, through the 

14 Director of the Centers for Disease Control and Pre15 vention, may award grants to eligible entities for the 

16 purpose of raising awareness for liver cancer and 

17 other liver diseases, which may include the produc18 tion, dissemination, and distribution of informational 

19 materials targeted towards communities and popu20 lations with a higher risk for developing liver cancer 

21 and other liver diseases. 

22 ‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re23 ceive a grant under paragraph (1), an entity shall 

24 submit to the Secretary an application, at such time, 

25 in such manner, and containing such information as 


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1 the Secretary may require, including a description of 

2 how the entity, in disseminating information on liver 

3 cancer and other liver diseases pursuant to para4 graph (1), will— 

5 ‘‘(A) with respect to any community or 

6 population, consult with members of such com7 munity or population and provide such informa8 tion in a manner that is culturally and linguis9 tically appropriate for such community or popu10 lation; 

11 ‘‘(B) highlight the range of treatments 

12 available for liver cancer and other liver dis13 eases; 

14 ‘‘(C) integrate information on available 

15 hepatitis B and hepatitis C testing programs 

16 into any liver cancer presentations carried out 

17 by the entity; and 

18 ‘‘(D) target communities and populations 

19 with a higher risk for contracting liver cancer 

20 and other liver diseases. 

21 ‘‘(3) PREFERENCE.—In awarding grants under 

22 paragraph (1), the Secretary shall give preference to 

23 entities that— 

24 ‘‘(A) are, or work with, a Federally quali25 fied health center; or 


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1 ‘‘(B) are community-based organizations. 

2 ‘‘(4) REPORT.—An entity that receives a grant 

3 under paragraph (1) shall submit to the Secretary, 

4 at a time specified by the Secretary, a report de5 scribing each activity carried out pursuant to such 

6 paragraph and evaluating the effectiveness of such 

7 activity in raising awareness for liver cancer and 

8 other liver diseases. 

9 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

10 For purposes of carrying out this subsection, there 

11 is authorized to be appropriated $10,000,000 for 

12 each of fiscal years 2020 through 2024. Any 

13 amounts appropriated under this paragraph shall re14 main available until expended and shall be used to 

15 supplement and not supplant other Federal funds 

16 provided for activities under this subsection.’’. 

17 SEC. 5. HEPATITIS B RESEARCH. 

18 Subpart 3 of part C of title IV of the Public Health 

19 Service Act (42 U.S.C. 285c et seq.) is amended by adding 

20 at the end the following new section: 

21 ‘‘SEC. 434B. HEPATITIS B. 

22 ‘‘The Director of the Institute shall, in collaboration 

23 with the Director of the National Institute of Allergy and 

24 Infectious Diseases, issue targeted calls for hepatitis B re25 search proposals focused on key research questions identiVerDate Sep 11 2014 00:53 Jun 08, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3016.IH H3016

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1 fied by the research community and discussed in peer-re2 viewed research journal articles.’’. 

3 SEC. 6. CHANGES RELATING TO NATIONAL INSTITUTE OF 

4 DIABETES AND DIGESTIVE AND KIDNEY DIS5 EASES. 

6 (a) CHANGE OF NAME OF NATIONAL INSTITUTE OF

7 DIABETES AND DIGESTIVE AND KIDNEY DISEASES.— 

8 (1) IN GENERAL.—Subpart 3 of part C of title 

9 IV of the Public Health Service Act (42 U.S.C. 285c 

10 et seq.) is amended in the subpart heading by strik11 ing ‘‘National Institute of Diabetes and Di12 gestive and Kidney Diseases’’ and inserting 

13 ‘‘National Institute of Diabetes and Diges14 tive, Kidney, and Liver Diseases’’. 

15 (2) TREATMENT OF DIRECTOR OF NATIONAL

16 INSTITUTE OF DIABETES AND DIGESTIVE AND KID17 NEY DISEASES.—The individual serving as the Di18 rector of the National Institute of Diabetes and Di19 gestive and Kidney Diseases as of the date of enact20 ment of this Act may continue to serve as the Direc21 tor of the National Institute of Diabetes and Diges22 tive, Kidney, and Liver Diseases commencing as of 

23 that date. 

24 (3) REFERENCES.—Any reference to the Na25 tional Institute of Diabetes and Digestive and KidVerDate Sep 11 2014 00:53 Jun 08, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H3016.IH H3016

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1 ney Diseases, or the Director of the National Insti2 tute of Diabetes and Digestive and Kidney Diseases, 

3 in any law, regulation, document, record, or other 

4 paper of the United States shall be deemed to be a 

5 reference to the National Institute of Diabetes and 

6 Digestive, Kidney, and Liver Diseases, or the Direc7 tor of the National Institute of Diabetes and Diges8 tive, Kidney, and Liver Diseases, respectively. 

9 (4) CONFORMING AMENDMENTS.— 

10 (A) Section 401(b)(3) of the Public Health 

11 Service Act (42 U.S.C. 281(b)(3)) is amended 

12 by striking ‘‘The National Institute of Diabetes 

13 and Digestive and Kidney Diseases.’’ and in14 serting ‘‘The National Institute of Diabetes and 

15 Digestive, Kidney, and Liver Diseases.’’. 

16 (B) Section 409A(a) of the Public Health 

17 Service Act (42 U.S.C. 284e(a)) is amended by 

18 striking ‘‘the National Institute of Diabetes and 

19 Digestive and Kidney Diseases’’ and inserting 

20 ‘‘the National Institute of Diabetes and Diges21 tive, Kidney, and Liver Diseases’’. 

22 (b) PURPOSE OF THE INSTITUTE.—Section 426 of 

23 the Public Health Service Act (42 U.S.C. 285c) is amend24 ed— 


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1 (1) by striking ‘‘National Institute of Diabetes 

2 and Digestive and Kidney Diseases’’ and inserting 

3 ‘‘National Institute of Diabetes and Digestive, Kid4 ney, and Liver Diseases’’; and 

5 (2) by striking ‘‘and kidney, urologic, and hem6 atologic diseases’’ and inserting ‘‘kidney, urologic, 

7 and hematologic diseases, and liver diseases’’. 

8 (c) DATA SYSTEMS AND INFORMATION CLEARING9 HOUSES.—Section 427 of the Public Health Service Act 

10 (42 U.S.C. 285c–1) is amended by adding at the end the 

11 following new subsection: 

12 ‘‘(d) The Director of the Institute shall (1) establish 

13 the National Liver Diseases Data System for the collec14 tion, storage, analysis, retrieval, and dissemination of data 

15 derived from patient populations with liver diseases, in16 cluding, where possible, data involving general populations 

17 for the purpose of detection of individuals with a risk of 

18 developing liver diseases, and (2) establish the National 

19 Liver Diseases Information Clearinghouse to facilitate and 

20 enhance knowledge and understanding of liver diseases on 

21 the part of health professionals, patients, and the public 

22 through the effective dissemination of information.’’. 

23 (d) REESTABLISHMENT OF LIVER DISEASE RE24 SEARCH BRANCH WITHIN DIVISION OF DIGESTIVE DISVerDate Sep 11 2014 00:53 Jun 08, 2019 Jkt 089200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H3016.IH H3016

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1 EASES AND NUTRITION AS DIVISION OF LIVER DIS2 EASES.— 

3 (1) IN GENERAL.—The Liver Disease Research 

4 Branch within the Division of Digestive Diseases 

5 and Nutrition of the National Institute of Diabetes 

6 and Digestive and Kidney Diseases (referred to in 

7 this subsection as the ‘‘Liver Disease Research 

8 Branch’’) is hereby redesignated and promoted as 

9 the Division of Liver Diseases, which shall be within 

10 the National Institute of Diabetes and Digestive, 

11 Kidney, and Liver Diseases, as redesignated by sub12 section (a), as a separate division from the other di13 visions within such Institute. 

14 (2) DIVISION DIRECTOR.—Section 428 of the 

15 Public Health Service Act (42 U.S.C. 285c–2) is 

16 amended— 

17 (A) in the section heading, by striking 

18 ‘‘DIVISION DIRECTORS FOR DIABETES, EN19 DOCRINOLOGY, AND METABOLIC DIS20 EASES, DIGESTIVE DISEASES AND NUTRI21 TION, AND KIDNEY, UROLOGIC, AND HEM22 ATOLOGIC DISEASES’’ and inserting ‘‘DIVI23 SION DIRECTORS FOR DIABETES, ENDO24 CRINOLOGY, AND METABOLIC DISEASES, 

25 DIGESTIVE DISEASES AND NUTRITION, 


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1 KIDNEY, UROLOGIC, AND HEMATOLOGIC

2 DISEASES, AND LIVER DISEASES’’; 

3 (B) in subsection (a)(1)— 

4 (i) in the matter preceding subpara5 graph (A), by striking ‘‘and a Division Di6 rector for Kidney, Urologic, and Hemato7 logic Diseases’’ and inserting ‘‘a Division 

8 Director for Kidney, Urologic, and Hem9 atologic Diseases, and a Division Director 

10 for Liver Diseases’’; and 

11 (ii) in subparagraph (A), by striking 

12 ‘‘and kidney, urologic, and hematologic dis13 eases’’ and inserting ‘‘kidney, urologic, and 

14 hematologic diseases, and liver diseases’’; 

15 and 

16 (C) in subsection (b)— 

17 (i) in the matter preceding paragraph 

18 (1), by striking ‘‘and the Division Director 

19 for Kidney, Urologic, and Hematologic 

20 Diseases’’ and inserting ‘‘the Division Di21 rector for Kidney, Urologic, and Hemato22 logic Diseases, and the Division Director 

23 for Liver Diseases’’; and 

24 (ii) in paragraph (1), by striking ‘‘and 

25 kidney, urologic, and hematologic diseases’’ 


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1 and inserting ‘‘kidney, urologic, and hem2 atologic diseases, and liver diseases’’. 

3 (3) TREATMENT OF DIRECTOR OF LIVER DIS4 EASE RESEARCH BRANCH.—The individual serving 

5 as the Director of the Liver Disease Research 

6 Branch as of the date of enactment of this Act may 

7 continue to serve as the Division Director for Liver 

8 Diseases commencing as of that date. 

9 (4) TRANSFER OF AUTHORITIES.—The Sec10 retary of Health and Human Services shall delegate 

11 to the Division Director for Liver Diseases all duties 

12 and authorities that were vested in the Director of 

13 the Liver Disease Research Branch as of the day be14 fore the date of enactment of this Act. 

15 (5) REFERENCES.—Any reference to the Liver 

16 Disease Research Branch, or the Director of the 

17 Liver Disease Research Branch, in any law, regula18 tion, document, record, or other paper of the United 

19 States shall be deemed to be a reference to the Divi20 sion of Liver Diseases, or the Division Director for 

21 Liver Diseases, respectively. 

22 (e) INTERAGENCY COORDINATING COMMITTEES.— 

23 Section 429(a) of the Public Health Service Act (42 

24 U.S.C. 285c–3(a)) is amended— 


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1 (1) in paragraph (1), by striking ‘‘and kidney, 

2 urologic, and hematologic diseases’’ and inserting 

3 ‘‘kidney, urologic, and hematologic diseases, and 

4 liver diseases’’; and 

5 (2) in the matter following paragraph (2), by 

6 striking ‘‘and a Kidney, Urologic, and Hematologic 

7 Diseases Coordinating Committee’’ and inserting ‘‘a 

8 Kidney, Urologic, and Hematologic Diseases Coordi9 nating Committee, and a Liver Diseases Coordi10 nating Committee’’. 

11 (f) ADVISORY BOARDS.—Section 430 of the Public 

12 Health Service Act (42 U.S.C. 285c–4) is amended— 

13 (1) in subsection (a), by striking ‘‘and the Na14 tional Kidney and Urologic Diseases Advisory 

15 Board’’ and inserting ‘‘the National Kidney and 

16 Urologic Diseases Advisory Board, and the Liver 

17 Diseases Advisory Board’’; and 

18 (2) in subsection (b)(2)(A)(i)— 

19 (A) by striking ‘‘the Director of the Na20 tional Institute of Diabetes and Digestive and 

21 Kidney Diseases’’ and inserting ‘‘the Director 

22 of the National Institute of Diabetes and Diges23 tive, Kidney, and Liver Diseases’’; and 

24 (B) by striking ‘‘and the Division Director 

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1 tive and Kidney Diseases’’ and inserting ‘‘and 

2 the Division Director of the National Institute 

3 of Diabetes and Digestive, Kidney, and Liver 

4 Diseases’’. 

5 (g) RESEARCH AND TRAINING CENTERS.—Section 

6 431 of the Public Health Service Act (42 U.S.C. 285c– 

7 5) is amended— 

8 (1) by redesignating subsection (e) as sub9 section (f); and 

10 (2) by inserting after subsection (d) the fol11 lowing new subsection: 

12 ‘‘(e) The Director of the Institute shall provide for 

13 the development or substantial expansion of centers for 

14 research in liver diseases. Each center developed or ex15 panded under this subsection— 

16 ‘‘(1) shall utilize the facilities of a single insti17 tution, or be formed from a consortium of cooper18 ating institutions, meeting such research qualifica19 tions as may be prescribed by the Secretary; 

20 ‘‘(2) shall develop and conduct basic and clin21 ical research into the cause, diagnosis, early detec22 tion, prevention, control, and treatment of liver dis23 eases and related functional, congenital, metabolic, 

24 or other complications resulting from such diseases; 


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1 ‘‘(3) shall encourage research into and pro2 grams for— 

3 ‘‘(A) providing information for patients 

4 with such diseases and complications and the 

5 families of such patients, physicians and others 

6 who care for such patients, and the general 

7 public; 

8 ‘‘(B) model programs for cost effective and 

9 preventive patient care; and 

10 ‘‘(C) training physicians and scientists in 

11 research on such diseases and complications; 

12 and 

13 ‘‘(4) may perform research and participate in 

14 epidemiological studies and data collection relevant 

15 to liver diseases in order to disseminate such re16 search, studies, and data to the health care profes17 sion and to the public.’’. 

18 (h) ADVISORY COUNCIL SUBCOMMITTEES.—Section 

19 432 of the Public Health Service Act (42 U.S.C. 285c– 

20 6) is amended— 

21 (1) by striking ‘‘and a subcommittee on kidney, 

22 urologic, and hematologic diseases’’ and inserting ‘‘a 

23 subcommittee on kidney, urologic, and hematologic 

24 diseases, and a subcommittee on liver diseases’’; and 


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1 (2) by striking ‘‘and kidney, urologic, and hem2 atologic diseases’’ and inserting ‘‘kidney, urologic, 

3 and hematologic diseases, and liver diseases’’. 

Æ 


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